CASE A 78-year-old woman who began hemodialysis treatment in September 2022 due to diabetes complications was referred to our interventional clinic due to pain in her dialysis arm during maintenance dialysis. The dialysis vessel type is radiocephalic fistular. On ultrasound examination, total occlusion of the basilic vein was observed, collateral vessels were observed in the deep vein. A 6Fr sheath was inserted into the juxta-anastomosis in the anterograde direction and wiring was attempted with 0.035 ‘’ wire. However, wiring toward the basilic vein with antegrade was not successful. Afterwards, access was attempted with a 0.018” RADIFOCUS guide wire, but access was consistently achieved only through the false lumen around the elbow. In order to pass the wire, it was decided to approach the basilic vein in a retrograde direction using the rendezvous technique. The upper basilic vein was punctured, a 6Fr sheath was inserted, and wiring in the retrograde direction was attempted through 0.035’’ and 0.018’’ wires, but entry was not achieved. Afterwards, the wire was replaced with 0.014” astato XS20 (Asahi, Aichi, Japan) and the procedure was performed. In fact, it was judged that the wire had passed in the 2D image, but when viewing the image from a different angle, it was confirmed that it had not passed. Afterwards, by rotating the patient's arm to obtain images from various angles and adjusting the angle of the wire tip, wiring was successful from retrograde to anterograde, and the wire that entered the retrograde entered the lumen of the catheter that entered the antegrade. Afterwards, the stenosis was dilated with a 4mm and 6mm balloon catheter, and successful patency was confirmed. Conclusions In patients undergoing dialysis vascular intervention where wiring is difficult, the rendezvous technique, which approaches both anterograde and retrograde simultaneously, can be a good alternative.